Individual
MISS KRISTEN DIANE GRANDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
510 E NAPLES ST, CHULA VISTA, CA 91911-2519
(619) 421-6083
Mailing address
2912 LANING RD, SAN DIEGO, CA 92106-6434
(858) 361-7948
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT25039
CA
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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